Intravenous and oral itraconazole versus intravenous amphotericin B deoxycholate as empirical antifungal therapy for persistent fever in neutropenic patients with cancer who are receiving Broad-spectrum antibacterial therapy: A randomized, controlled trial

Boogaerts, M., Winston, D.J., Bow, E.J., Garber, G., Reboli, A.C., Schwarer, A.P., Novitzky, N., Boehme, A., Chwetzoff, E., de Beule, K. and Phillips, E. (2001) Intravenous and oral itraconazole versus intravenous amphotericin B deoxycholate as empirical antifungal therapy for persistent fever in neutropenic patients with cancer who are receiving Broad-spectrum antibacterial therapy: A randomized, controlled trial. Annals of Internal Medicine, 135 (6). pp. 412-422.

Abstract

Prolonged neutropenia is a major risk factor for invasive fungal infection (1–6). The incidence among neutropenic patients with cancer who are receiving intensive cytotoxic therapy ranges from 2% to 47%, depending on other concomitant risk factors (7). Mortality rates range from 35% to 90% (8). Fever may be the only clinical sign of infection, and definitive diagnosis is often problematic. Empirical therapy with amphotericin B deoxycholate reduces the relative risk for documented infection by 50% to 80% and overall mortality rates by 23% to 45% (1–2, 9–10). This practice is now standard in neutropenic patients with cancer who have persistent fever that does not respond to 3 to 7 days of treatment with broad-spectrum antibiotics (11).

Item Type:	Journal Article
Publisher:	American College of Physicians
Notes:	Elizabeth Phillips appears on behalf of the Itraconazole Neutropenia Study Group
URI:	http://researchrepository.murdoch.edu.au/id/eprint/16105

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